Abstract: Objective To investigate the incidence of failure in intramedullary fixation for intertrochanteric fracture,and discuss the risk factors associated with the failure and provide basis for the treatment. Methods The clinical data of 367 cases of intertrochanteric fractures in Panjin central hospital between January 2010 and December 2013 were retrospectively analyzed.All the patients were confirmed by X-ray,CT examination and clinical symptoms,and underwent the intramedullary fixation.The incompatible cases were excluded before the study and the incidence of fixation failure were recorded.All 367 patients included in the study were divided into successful fixation group(316 cases) and failure fixation group(51 cases) based on the fixed effect.The questionnaire on risk factors was made,and univariate analysis and Logistic analysis were used to assess the risk factors. Results Among 367 cases,51 cases failed in fixation with an rate of 13.9%.Univariate analysis results showed that the age,fracture type,reset level,osteoporosis,fixed position and underlying disease were the individual risk factors for the failure.Logistic analysis showed that the age,fracture type,reset level,osteoporosis,fixed position and underlying disease were the independent risk factors for the failure in intramedullary fixation. Conclusion After the intramedullary fixation treatment,fixation failure are not rare.And the age,fracture type,reset level,osteoporosis,fixed position and underlying disease are the risk factors for the failure in intramedullary fixation.So the risk factors should be paid more attentions in the treatment and nursing of intertrochanteric fracture.